I'd ask What I Should or Shouldn't Be Eating, but I can't Keep Anything Down Anyway And Other, Largely Useless Advice

The standard advice is to eat crackers or some similar carbohydrate that is bland before getting out of bed. Ginger ale, ginger tea and ginger candy are also often suggested. Nausea during the first trimester is more normal than not, and to the degree that it relates to outcomes, nausea is a good sign. Losing a little weight because it is so difficult to keep food down in the first trimester will almost certainly not harm your baby (it won't grow much for a while yet anyway) or you (assuming you didn't start this pregnancy dangerously underweight). While exercise or physical activity might help with the nausea and is therefore worth a try, it may make it worse. Extra naps and more hours in bed at night will both feel good and be good for you.

The nausea I experienced during my first trimester was not quite like any other nausea I'd experienced. Given that I get motion sickness in cars, trains, planes and a lot of amusement rides, I figured I knew what nausea could be like. This was weird stuff. It wasn't horrible, but it was unending and remarkably resistant to usual comfort measures. However, a quarter tab or half tab of Dramamine made it a lot less miserable and made napping even easier, with the beneficial effect of clearing up my allergies (which were giving me trouble, since I'd quit taking Claritin after reading about hypospadias, a precaution that was probably not necessary).

In between naps, I tried to do some research on what I should and shouldn't be doing while pregnant and, rather belatedly, tried to figure out who I wanted to deliver my baby. I'd heard about the no-sushi rule, which has two components to it. First, it's hard to be sure there are no parasites in raw fish. Second, some kinds of fish, cooked or otherwise, have a lot of mercury and that can do neurological damage in adults and even worse damage in a developing baby. I still eat sushi, but I usually have a salmon skin roll and unagi with a salad and look longingly at the spicy tuna and decide it won't kill me to wait a few months. I also cut slightly back on my consumption of tuna fish sandwiches in favor of turkey.

While doing this research, I ran into a laundry list of other things that pregnant women can worry about, including toxoplasmosis (which you can get from changing litter boxes) and cytomegalovirus (which you won't notice, but if you get it during the wrong weeks in your pregnancy, can do a lot of damage to the wee one). While you are pregnant would be an unfortunate time to get chickenpox. There are also warnings about overheating and cooking the baby, either through exercise (unlikely) or through hot tubs (possible if you're inclined to submerge yourself relatively completely and raise your core temperature by more than a degree or two). You may or may not choose to pay any attention to these optional sources of worry. Few books make much out of the extremely real dangers of being in a car accident or being beaten up by a significant other. Some say to wear your seat belt (good advice, and the law in many areas anyway) in the first case. I'm not in a position to give you advice about what to do if you are in a physically abusive (or otherwise abusive) relationship, other than to note that pregnancy can cause these situations to get much, much worse; your own life could be in great danger. If you have people you can go to for advice and assistance, I would certainly encourage you to do so when you feel you can.

If you have to be premedicated when you go to the dentist (you know what this means if you do, otherwise, don't worry about it), your dentist will probably refuse to see you once you are pregnant. Otherwise, regular cleanings are even more important now. Tell them you are pregnant if they want to do routine x-rays. They will almost certainly put them off until you are no longer pregnant. If the dentist thinks it's important enough to do an x-ray anyway, talk to them about the tradeoffs and feel free to put it off for a day or so while you think about how you feel about it. Dental x-rays, in principle, are quite safe, assuming they're using the aprons and so forth. But that's right up there with microwaves are quite safe, unless they're old and the seal has broken down (in which case, simply standing back from the microwave removes the danger anyway). Pregnancy hormones tend to make gingivitis worse if you have it, and may start it if you don't. An obvious corollary to this observation is that brushing at least twice a day, and flossing at least once a day will help keep the tender/bleeding gum problem somewhat under control.

X-rays used to be used quite cavalierly during pregnancy, to image the baby, and to assess the size of the mother's pelvis in the hopes of being able to tell if she had a large enough pelvis for a (or, ideally, this particular) baby to fit through. This was an incredibly stupid thing to do, increased leukemia rates in the babies later on in life, and didn't supply useful information anyway. The most basic understanding of women's anatomy told them the pelvis is remarkably flexible during birth and cannot be accurately measured ahead of time. Further, their selection of postures (on back) for birth cuts the size of the pelvis down by 30% so the whole cephalo-pelvic disproportion (CPD) in the post-rickets era (a woman with rickets may have a very small pelvis with a weird shape to it) is pretty much a doctor-caused problem. And of course, position of the baby while it is being born matters a great deal. But when contemplating an x-ray for a much needed dental procedure, it pays to realize that far, far more dangerous uses of x-rays were routinely advocated in the past by doctors, and for much less of a payoff for mom.

Many, many, many of our mothers in the U.S. smoked and/or drank when they were pregnant with us. There was also a much more cavalier attitude towards medication during pregnancy. The assumption was that the placenta completely protected the unborn child. While we now know that is not the case, there is no cause to get all over anyone's case about their smoking, drinking, food, medication or supplementation decisions. Advice is not without risks and each woman's life is a difficult set of tradeoffs. Ordering a woman to engage in "or refrain from" a particular, legal action in the hypothetical interests of her as yet unborn and honestly, decently high-risk of being miscarried during the first trimester offspring can not be considered polite or compassionate. Please don't do it.

Supplementation

Other than folic acid, there is little evidence to support recommending supplements for pregnant women in general. Consider carefully the larger issues around supplementation, and the rationale for whatever supplements others advise you to take.

Other Medications

The Difficulty of Finding Out Whether The Meds You Take Are Safe

Why Does Dad Get a Free Pass, Anyway?

On the one hand, dad isn't getting a free pass. In fact, dad is increasingly being subjected to the same list of largely useless advice that has been inflicted on women for a long time. Don't do this long list of things (generally you're told far too late to do anything about it. Do do this other list of things, which may be good but largely unattainable and might actually be a not-so-good idea (supplementation), but mostly isn't particularly relevant. Toss in a bunch of not-particularly-trustworthy numbers and voila.

There is a whole section of medicine called "maternal and infant health". While recognition that infants do not come from nowhere is probably progress, and that mothers aren't going to be healthy if you ignore their babies and babies aren't going to be healthy if you ignore their mothers is also progress, the absence of the father is notable. And there is always a father, even if only biologically, at least in human reproduction which is what this is all about. But before we get to that father, or at least that father's germ cells, let's take a quick look at what the CDC has to say about Maternal and Infant Health. At the time I accessed this page, women, mothers, pregnant women are repeatedly mentioned. Men, fathers are nowhere mentioned. The gender neutral "parent" appears exactly once and no, it is not in the context of you should stop smoking, don't beat the mother of your child, and obey all laws and rules of the road while driving her/them around (advice that would at least be directed at the high probability risks to the dyad). It is in the context of possibly having to evacuate due to fire. Given our culture's imagery around men and fire, apparently this was one instance in which men could be mentioned in the context of maternal and infant health.

It is easy to imagine that the sperm which provides half the nuclear genetic material to make the new human(s) might have some problems with it. Some of those problems might have been present in dad when he was conceived. Some of those problems might be a more or less inevitable artifact of dad's age and/or sexual habits. Some of those problems might be an artifact of what dad has eaten recently or over the course of his life, what he has been exposed to on the job or at play -- what medications his mother took when she was pregnant with him, whether he was formula fed or breastfed. You could go on and on. There's not a helluva lot of information out there about any of this, in much the same way that decades ago it wasn't possible to find information about the effects of maternal exposure to mercury, or smoking, or pthalates, or Bisphenol-A or whatever on a developing baby. That is not reassuring.

It is extremely easy to find people who are fully prepared to really get after a pregnant woman for smoking. It is not as easy to find people who are similarly prepared to get dear old dad to stop smoking. And it has been damn hard to pass laws to fully eliminate smoking in workplaces where women might be working while pregnant (bars, notably). Unsurprisingly, secondhand smoke is probably as bad for the fetus as maternal smoking, a conclusion reached by pooling data from multiple studies which had discounted the risk.

DNA is DNA and damaged DNA is damaged DNA. We get half from each parent, and yet we almost never worry about lifetime radiation exposure risk in men the way we do in "women of reproductive age". We are only just starting to pay attention to paternal DNA damage -- and there's a chance it's more important than maternal DNA damage, at least in other species.

People worry about whether a woman diagnosed with breast cancer to proceed with treatment during a pregnancy. They should perhaps be asking whether a man being treated for cancer should be engaging in potentially reproductive sex. At least in rats, some cancer treatments do significant damage to sperm cells, and that damage does not always prevent viability. The American Cancer Society at least mentions the issue.

I would hate to see us resolve a gender-imbalance in unwanted, useless advice by inflicting the same advice on both genders, but that does seem to be the way we are headed. Perhaps one day, when our children are off at college, we can distract ourselves from worrying about what they are doing when we can't keep an eye on them anymore by improving the safety of the world for everyone.


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Copyright 2005 by Rebecca Allen
Created May 20, 2005 Updated December 30, 2010